
Back Pain
Rapid Review
- Differentials
- “CRAFTI”
- Compression
- Cauda equina
- Conus medullaris
- Epidural hematoma
- Renal stone
- Aortic aneurysm/dissection
- Fracture
- Tumor
- Infection/Inflammatory
- Pyelonephritis
- Perinephric abscess
- Epidural abscess
- Osteomyelitis
- Discitis
- Transverse myelitis
- Compression
- Other common causes
- Mechanical low back pain
- Sciatica/Radiculopathy
- “CRAFTI”
- History
- Recent injury
- Consider fracture, strain
- Recent unintentional weight loss
- Consider malignancy
- IV drug use
- Consider epidural abscess
- Syncopal episode
- Consider aortic dissection, aneurysm
- Urinary incontinence or saddle anesthesia
- Consider cauda equina
- Fever/chills
- Consider infectious process
- Recent injury
- Physical Exam
- Spinal tenderness. Step-off deformity.
- Consider fracture
- CVA tenderness
- Consider nephrolithiasis or pyelonephritis
- Sphincter dysfunction
- Consider cauda equina
- Spinal tenderness. Step-off deformity.
- Work-Up
- Labs
- CBC, BMP, ESR, CRP
- Urinalysis
- Beta-hCG
- Post-Void Residual
- Imaging
- X-ray (spinal)
- CT Spine (non-contrast)
- Labs
Pearls
Deep Dive

Chest Pain
Rapid Review
- Differentials
- Cardiovascular
- Acute coronary syndrome
- Aortic dissection
- Pericarditis
- Pulmonary
- Pulmonary embolism
- Pneumothorax
- Pneumonia
- Gastrointestinal
- Boerhaave’s Syndrome
- Pneumomediastinum
- Gastroesophageal Reflux (GERD)
- Thoracic Wall
- Costochondritis
- Rib contusion/fracture
- Shingles
- Psychiatric
- Anxiety/Panic attack
- Cardiovascular
- History
- Ripping/tearing pain
- Consider aortic dissection
- Exertional
- Consider ACS, heart failure
- Pleuritic
- Consider PE, pericarditis, pneumonia
- Positional
- Consider pericarditis or myocarditis
- Estrogen use
- Consider PE
- Hx of HTN, HLD, DM, or PVD
- Consider ACS
- Prior cardiac procedures (stents, bypass, echo, catheterization, etc.)
- Consider ACS or surgical complications
- History of anxiety
- Consider panic attack
- Fever/Chills
- Consider pneumonia or other infectious causes
- Ripping/tearing pain
- Physical Exam
- JVD
- Suggests right-sided HF
- New murmurs
- Consider valvular dysfunction
- Abnormal lung sounds (rales, rhonchi, wheezing)
- Consider pneumonia, CHF exacerbation, etc.
- Chest wall tenderness
- Consider costochondritis, pericarditis
- Edema
- Consider heart failure
- JVD
- Work-Up
- EKG
- Look for bradycardia, tachycardia, ST-segment elevation/depression,
- Labs
- CBC, BMP
- Troponin
- D-Dimer
- Imaging
- CXR
- CT PE (if concern for pulmonary embolism)
- CT aortogram (if concern for aortic dissection
- Echocardiogram (if concern for pericardial effusion)
- EKG
Pearls
Deep Dive

Palpitations
Rapid Review
- Differentials
- Arrhythmias
- Sinus tachycardia
- AVRT/AVnRT
- Atrial flutter
- Atrial fibrillation
- Multifocal Atrial Tachycardia
- Ventricular Tachycardia
- PVC’s or PAC’s
- Valvular Disease
- Mitral or aortic insufficiency
- Mitral valve prolapse
- Psychiatric
- Panic attack
- Anxiety
- Somatization
- Depression
- Drug/Medication Use
- Caffeine
- Amphetamines
- Cocaine
- Aspirin overdose
- Alcohol/Opiate withdrawal
- Other
- ThyrotoxicosisAnemia
- Addisonian Crisis
- Carcinoid Syndrome
- Arrhythmias
- History
- Recent ingestion of substance
- Consider caffeine, amphetamines, or alcohol
- Recent stressors
- Consider anxiety, depression, panic disorder
- Associated with chest pain/SOB on exertion
- Consider ACS, CHF, valvular disorders
- Recent ingestion of substance
- Physical Exam
- Murmurs
- Consider valvular dysfunction
- JVD
- Consider heart failure
- Irregularly irregular heart rate
- Consider atrial fibrillation/flutter
- Murmurs
- Work-Up
- EKG
- Labs
- CBC, BMP
- Troponin
- TSH + Free T4
- Urine drug screen
- Pregnancy test
Pearls
Deep Dive

Shortness of Breath
Rapid Review
- Differentials
- Airway
- Airway obstruction
- Anaphylaxis
- Abscess or tumor
- Breathing
- Asthma
- Pulmonary embolism
- COPD exacerbation
- Pleural effusion
- Noncardiogenic edema
- Pneumothorax
- Pneumonia
- Cardiac
- Congestive heart failure
- Pericardial effusion/Cardiac tamponade
- Acute Coronary Syndrome
- Arrhythmia
- Valvular dysfunction
- Other
- Anemia
- Anxiety/Panic attack
- Trauma (pulmonary contusion/flail chest)
- Diabetic Ketoacidosis
- CO poisoning
- Airway
- History
- Exertional
- Suggests ACS, HF, or PE
- History of previous lung disorders
- Consider COPD, Asthma
- Hx of diabetes
- Consider DKA
- History of cardiac disorders
- Consider ACS, HF, valvular problems
- Recent trauma
- Consider pneumothorax, pulmonary contusion
- Recent travel/immobilization. Estrogen use
- Consider pulmonary embolism
- Fever/chills
- Consider infectious causes
- Exertional
- Physical Exam
- Apparent distress or tripod positioning
- Consider need for urgent airway/breathing management
- Murmurs, rubs, gallops
- Consider HF, pericarditis
- JVD
- Consider right-sided HF
- Abnormal lung sounds (rales, rhonchi, wheezing)
- Consider HF, asthma, COPD, pneumonia
- Apparent distress or tripod positioning
- Work-Up
- EKG
- Labs
- CBC, BMP, troponin, d-dimer, BNP
- Imaging
- CT PE (if considering pulmonary embolism)
- Echo (if suspect effusion, HF)
Pearls